Implication of endoplasmic reticulum stress and mitochondrial perturbations in remote liver injury after renal ischemia/reperfusion in rats: potential protective role of azilsartan

Objectives: Distant liver injury is a complication of renal ischemia-reperfusion (I/R) injury, which imposes mortality and economic burden. This study aimed to elucidate the cross-talk of endoplasmic reticulum (ER) stress and mitochondrial perturbations in renal I/R-induced liver injury, and the potential hepatoprotective effect of azilsartan (AZL).Methods: Male albino Wister rats were pre-treated with AZL (3 mg/kg/day, PO) for 7 days then a bilateral renal I/R or sham procedure was performed. Activities of liver enzymes were assessed in plasma. The structure and ultra-structure of hepatocytes were assessed by light and electron microscopy. Markers of ER stress, mitochondrial biogenesis and apoptosis were analyzed in livers of rats.Results: Renal ischemic rats showed higher plasma levels of liver enzymes than sham-operated rats, coupled with histological and ultra-structural alterations in hepatocytes. Mechanistically, there was up-regulation of ER stress markers and suppression of mitochondrial biogenesis-related proteins and enhanced apoptosis in livers of renal ischemic rats. These abnormalities were almost abrogated by AZL pretreatment.Discussion: Our findings uncovered the involvement of mitochondrial perturbations, ER stress and apoptosis in liver injury following renal I/R, and suggested AZL as a preconditioning strategy to ameliorate remote liver injury in patients susceptible to renal I/R after adequate clinical testing.

Morphological, biochemical, and histopathological effects of levetiracetam on pregnant albino rats and their offspring

One of the most widely used medications for epilepsy is the broad-spectrum antiseizure levetiracetam. The study aimed to evaluate the impact of levetiracetam on the bodyweight and liver of pregnant rats and their offspring. The study involved treating the rats during pregnancy and lactation and then examining the pregnant rats and their offspring. Two groups of 40 pregnant rats were created (I, II). Each group was split up into two smaller groups (A, B). About 1.5 mL/day of distilled water was gavaged to the rats in group I, either continuously throughout pregnancy (IA) or continuously throughout pregnancy and 15 days after delivery (IB). Group II rats received 1.5 ml/day of distilled water (containing levetiracetam) either during pregnancy (IIA) or during pregnancy plus 15 days postpartum (IIB). At the end of the work, blood samples were taken from the adult rats, body weight of different groups were recorded, and then, their liver was subjected for histological and morphometric analysis. Levetiracetam treatment showed reduction in the body weight of adult rats and their offspring and pathological changes in their liver. These changes were in the form of distortion of the hepatic architecture, cytoplasmic vacuolation, nuclear changes, and swollen mitochondria with loss of their cristae. Such changes were proved by alteration in alanine aminotransferase (ALT) and aspartate aminotransferase (AST) enzyme levels of the liver. It is advised to monitor the liver functions continuously when using levetiracetam.

Technostress Creators and Outcomes Among Egyptian Medical Staff and Students: A Multicenter Cross-Sectional Study of Remote Working Environment During COVID-19 Pandemic

Objectives

This study aimed to investigate the technostress creators and outcomes among University medical and nursing faculties and students as direct effects of the remote working environment during the COVID-19 pandemic.

Background

Due to the current COVID-19 pandemic, shifting to virtual learning that implies utilizing the information and communication technologies (ICTs) is urgent. Technostress is a problem commonly arising in the virtual working environments and it occurs due to misfitting and maladaptation between the individual and the changeable requirements of ICTs.

Methods

A multicenter cross-sectional study was conducted in medicine and nursing colleges of 5 Egyptian universities and included both staff members and students. The data were collected through personal interviews, from January to May 2021. All the participants took a four-part questionnaire that asked about personal and demographic data, technostress creators, job or study, and technical characteristics and technostress outcomes (burnout, strain, and work engagement). Furthermore, participants' blood cortisol and co-enzyme Q10 (CoQ10) levels were tested in a random sample of the students and medical staff.

Results

A total of 3,582 respondents participated in the study, 1,056 staff members and 2,526 students where 33.3% of the staff members and 7.6% of students reported high technostress. Among staff members, total technostress score significantly predicted Cortisol level (β = 2.98, CI 95%: 0.13-5.83), CoQ10(β = −6.54, CI 95%: [(−8.52)–(−4.56), strain (β = 1.20, CI 95%: 0.93–1.47), burnout (β = 0.73, CI 95%: 0.48–0.97) and engagement (β = −0.44, CI 95%: [(−0.77)–(−0.11)]) whereas among students, total technostress score significantly predicted cortisol level (β = 6.64, CI 95%: 2.78–10.49), strain (β = 1.25, CI 95%: 0.72–1.77), and burnout (β = 0.70, CI 95%: 0.37–1.04). Among staff members and students, technology characteristics were significantly positive predictors to technostress while job characteristics were significantly negative predictors to technostress.

Conclusion

The Egyptian medical staff members and students reported moderate-to-high technostress which was associated with high burnout, strain, and cortisol level; moreover, high technostress was associated with low-work engagement and low CoQ10 enzyme. This study highlighted the need to establish psychological support programs for staff members and students during the COVID-19 pandemic.